Planning is less effective than strategy and strategy is most effective when strengthened through the Scenario Survey Process.
Oct 12 2011
When I read the practice management presentation topics of many organized medical societies, I’m stunned by the degree of victimhood and of loss of choice assumed.
Topics such as how to deal with engulfment by the ACO, negotiating with the management company selected by the hospital, and selling out to the hospital.
Why do the leaders of these organizations assume that an unwanted system can be imposed on their members?
Not every profession or specialty has a future. Job openings for ice deliverymen plummeted with the invention of Freon and the popularity of home refrigerators. It would have done little good for ice deliverymen to protest.
Is this what these medical group leaders are saying? That there is no future for their members?
Or, is there a future, but the leaders aren’t leaders, they are collaborators? Healthcare collaborators, that is.
Mark F. Weiss
Oct 10 2011
A few days ago I heard another of what is becoming a familiar story.
A hospital had dumped its longstanding hospital-based contractor (this time an anesthesia group) in favor of a “national practice.” The national practice presented well – lots of guys in nice suits and far better graphics on their presentation materials than the old group. And the old group “cost” too much.
Of so the hospital thought.
But the suits were empty. The national group wasn’t a group at all. It was a staffing, or rather, a billing, service. And it couldn’t or wouldn’t recruit to full strength. The hospital’s business faltered, resulting in the loss of millions.
Flash forward to a few days ago. Less than a year after it arrived, the national group has been given notice of termination. The hospital’s CFO, who championed the cost savings, has been fired.
Mark F. Weiss
Oct 07 2011
If your medical group signals its weakness, it will become easy prey.
Oct 05 2011
What an odd color Mercedes; pink, like cotton candy.
But what color is that pink? The pink in your mind’s eye is different from that in mine, and from that of each other reader.
That’s because colors are perceptions made by each of us.
The three students filed into the room and took seats facing the large screen. A block of color was projected onto it.
“What color is the block?” asked a voice from the back of the room.
“Blue – Blue – Blue,” they replied.
“White – White – White.”
“And this block?”
“Green – Green – Wait, that block isn’t green, it’s pink!”
No, not a difference in perception, but a college psych study of compliance. Will the test subject, the third student, parrot the obviously erroneous answer of the two confederates? Will he say that pink is green?
So what’s the right way of looking at ACOs, physician alignment, hospital-physician collaboration and other initiatives to bind physicians to hospitals?
Is it that I, like you, see the true color – control not alignment, top down authority not participation, lockstep factory medicine as opposed to individualized patient care, cookbook versus innovation?
Or is it simply a matter of seeing the same color in slightly different ways?
The test, I suppose, is to construct a collaborative deal in the manner of what’s commonly referred to as a Dutch auction: One party names the price and the other chooses to be the buyer or the seller. Or your brother splits the brownie and you choose the bigger “half.”
So, if collaboration really is the real thing, let the hospital design the deal, but the physicians control it.
The hospital’s CEO is turning pink! What color, exactly?
Mark F. Weiss
Oct 03 2011
The tides come in and out, ties get wider then narrower then wider again, and society cycles round and round from “me” to “we.”
Today’s society is heavily affected by “we” think, from notions of shared sacrifice, to paying your fair share, to “giving back.”
Not every individual or entity in a society buys into the current stage of the cycle and that’s why trends eventually moderate and return toward the antipode. However, there are some who, while holding a view closer to the other extreme, understand that they can benefit from co-opting the current zeitgeist.
Thus the move by hospitals to take advantage of “we” think.
As the current wave of collectivism shapes trends in healthcare, hospitals seek to ride that wave to further their own “me” interests: Witness the completely hospital-centric notions of Accountable Care Organizations, healthcare collaboration, and integrated delivery systems.
Physicians are told that the future of healthcare is not in rugged individualism but, rather, in the “it takes a village” world.
But they are being told that by the hospital that wants to be the mayor of the village.
Mark F. Weiss
Sep 30 2011
Stop kidding yourself that the delivery of expert, even world-class, medical care is sufficient to guarantee your group’s future. Understand how to identify and incentivize high level customer service.
Sep 28 2011
It’s said that Henry Ford adopted the modern production line, with each worker focusing on a part instead of assembling a whole, from his observations of the way that Chicago slaughterhouses “dressed” pigs.
On October 1, 1908, the first Model T rolled off the production line. Available, famously, in any color you wanted as long as that color was black.
Ford focused on keeping things simple, building one model that (had to) suit all, using interchangeable parts that relatively unskilled workers could assemble.
How different is this from the model of healthcare envisioned by many today? “Best practices” replacing innovation. One model replacing high touch care. Delivery via relatively unskilled workers (paraprofessionals).
In the end, the public wanted more – and the Model T rode off into history. History is sure to repeat itself.
Mark F. Weiss
Sep 26 2011
The marketplace for hospital based services is becoming increasingly commoditized.
Along with it, we’re seeing the growth of large commodity providers with a commodity type business plan: Provide the level of service that is minimally required. Provide that service through low cost providers in order to upstream the profits. Make money on volume.
The selling point to facilities is low to no stipend support. After all, from the hospital standpoint, isn’t low or no stipend support a cost saving deal?
Maybe. Maybe not. You often get what you pay for.
You can buy a cheap pair of dress shoes that will crack and wear out in a year or you can buy shoes with an initial high price tag with much more supple leather and better craftsmanship that will last, with upkeep, more than a decade. Which pair was actually less expensive?
In similar fashion, is it less expensive to reduce a stipend by $300,000 but to lose $1,000,000 through the destruction of O.R. efficiency or the skyrocketing increase in hospital negligence litigation?
Perhaps this issue won’t play out in the court of public opinion but in the court of law?
Mark F. Weiss
Sep 23 2011
The dominant business and financial paradigm for many physicians, especially hospital-based specialists, is that they are a commodity, a valuable one, perhaps, but a commodity nonetheless. If you are ever to break out of the current paradigm, it will not be by benchmarking to the best practices of other groups headed downward in the same maelstrom.